School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland Q422, Australia.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA.
Diabetes Res Clin Pract. 2022 Jul;189:109965. doi: 10.1016/j.diabres.2022.109965. Epub 2022 Jun 16.
This meta-analysis aims to update former meta-analyses from randomized controlled trials (RCT) focused on the efficacy of CBT for diabetes.
Five databases were searched for RCTs. Primary outcomes were glycated hemoglobin (HbA), fasting blood glucose (FBS), systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI). Secondary outcomes were depression, anxiety and distress symptoms, quality of life, sleep quality.
32 RCTs were included. Results revealed that CBT could reduce HbA: -0.14% (95% CI: -0.25 to -0.02%, P = 0.020); FBS: -15.48 mg/dl (95% CI: -30.16 to -0.81 mg/dl, P = 0.040); DBP: -2.88 mmHg (95% CI: -4.08 to -1.69 mmHg, P < 0.001); depression symptoms: -0.90 (95% CI: -1.22 to -0.57, P < 0.001); anxiety symptoms: -0.28 (95% CI: -0.50 to -0.07, P = 0.009); improve sleep quality: -0.92 (95% CI: -1.77 to -0.07, P = 0.030). Subgroup analysis indicated that CBT has siginificantly reduced HbA when delivered as a group-based and face-to-face method, and psycho-education, behavioral, cognitive, goal-setting, homework assignment strategies were applied as central strategies.
CBT was an effective treatment for diabetes patients, significantly reduced their HbA, FBS, DBP, depression and anxiety symptoms, and improved sleep quality.
本荟萃分析旨在更新之前专注于认知行为疗法(CBT)治疗糖尿病疗效的随机对照试验(RCT)的荟萃分析。
在五个数据库中搜索 RCT。主要结局指标为糖化血红蛋白(HbA)、空腹血糖(FBS)、收缩压(SBP)、舒张压(DBP)和体重指数(BMI)。次要结局指标为抑郁、焦虑和困扰症状、生活质量、睡眠质量。
纳入 32 项 RCT。结果表明,CBT 可降低 HbA:-0.14%(95%CI:-0.25 至 -0.02%,P=0.020);FBS:-15.48mg/dl(95%CI:-30.16 至 -0.81mg/dl,P=0.040);DBP:-2.88mmHg(95%CI:-4.08 至 -1.69mmHg,P<0.001);抑郁症状:-0.90(95%CI:-1.22 至 -0.57,P<0.001);焦虑症状:-0.28(95%CI:-0.50 至 -0.07,P=0.009);改善睡眠质量:-0.92(95%CI:-1.77 至 -0.07,P=0.030)。亚组分析表明,当以小组为基础和面对面的方式提供 CBT 时,CBT 显著降低了 HbA,并且应用心理教育、行为、认知、目标设定、作业分配策略作为核心策略。
CBT 是一种有效的糖尿病治疗方法,可显著降低 HbA、FBS、DBP、抑郁和焦虑症状,并改善睡眠质量。